Each year during open season I request brochures from providers of interest and review Section 2 to see what is changing for the new year. I also review Section 9 to confirm what each plan covers when you are enrolled in Medicare and check the coverage for areas where we know we will need services in the upcoming year.

I’ve been with GEHA Standard, the MetLife Standard Dental Plan and FEP Blue High Option Vision care plans for many years and they have served my wife and I well. Most years, I review the plan brochures for program changes and haven’t had a reason to change until this year. I attended a FEHB Open House at the Greater Pittsburgh International Airport’s Air Traffic Control Tower to compare plans with health provider representatives. This is where I worked prior to retiring and I was also able to catch up with fellow workers and old friends.

The GEHA and Blue Cross Blue Shield handouts covered their plan offerings in colorful illustrated brochures for their 2020 Medical Benefits, Dental Benefits, Vision Care, and Medicare Benefits. There were three companies at the fair, GEHA, Blue Cross Blue Shield and UPMC. I believe all of the companies provide similar brochures that you can request from the providers. The GEHA brochures were exceptional with color tabs and I was able to go immediately to the section of interest. Their representative, John Repici was very helpful and answered all of my questions.

The plan brochures along with OPM’s FEHB Plan Comparison Tool and the BENEFEDS’ Plan Comparison Tool simplified my review and helped me select the best coverage for our changing circumstances. Register online at www.BENEFEDS.com to review and download plan brochures, use their plan comparison tool, and to initiate a change.

I’ve had a number of back and neck problems this last year and needed a plan that covers extensive chiropractor care. Hearing aids are another consideration and we travel and may not always find an in-network provider so that too was a factor.

After comparing several plans including Blue Cross Blue Shield Basic to GEHA Standard we decided to stay with GEHA Standard, it made sense for us plus the Blue Cross Blue Shield Basic plan doesn’t cover anything for out-of-network providers. The monthly premium for GEHA’s Self Plus One Standard plan was only $282.05 compared to $386.99 for Blue Cross Blue Shield’s Basic, a monthly savings of $104.94. We use this savings to offset our Medicare Part B premium costs.

Since my wife and I have Medicare A & B it made sense for us to enroll in a lower cost FEHB plan because most FEHB plans pick up the vast majority of our co-insurance, co-payment and deductible costs for Medicare enrollees. Since my wife and I signed up for Medicare about 5 years ago, we haven’t paid any deductibles, co-insurance or co-payments except for prescriptions.

After reviewing dental plans, we decided to move from MetLife Standard to a GEHA Standard plan. The cost savings were minimal, about a dollar monthly. The big difference was the increased coverage from $1,500 per person per year to $2,500 a person. A $1,000 increase in coverage for each of us. With the GEHA Standard plan you don’t pay anything for preventive care for in or out-of-network providers and there were other savings such as paying 15% less for out-of-network intermediate services. The comparison that I ran on BENEFEDS.com helped me make my decision. I initiated the change online and received a confirmation within a few minutes.

There are reasons for those needing orthodontic care to be cautious. With GEHA Standard and the FEP Blue Dental Standard plans you have a 12-month waiting period before you can use their orthodontic services. If you have young children that will need orthodontic care shortly consider MetLife, the FEP Blue Dental High Option plan, the GEHA High Option Plan and other plans that don’t require a waiting period. The FEP Blue high option provides unlimited maximum annual coverage for in-network providers and GEHA offers the same for both in and out-of-network providers.

There is a lot to consider this open season. Use our 2020 FEHB Plan Selection Guide to find all of the information you need to make an informed health care plan decision this open season.

Scheduling A Retirement Benefits Seminar

Federal Employee Benefits Advocates (FEBA) provides comprehensive benefit briefings for Federal employees so they can make informed retirement decisions. Briefings include information on CSRS or FERS Retirement Annuities and all insurance programs including Medicare, the Thrift Savings Plan (TSP), Social Security, disability and other relevant retirement planning topics.

Benefits Administration Letter 11-104 requires agencies to educate employees on how to plan for retirement. FEBA assists Federal agencies to comply with this directive. HR departments can Contact FEBA to schedule briefings for their area.

Disclaimer:Opinions expressed herein by the author are not an investment or benefit recommendation and are not meant to be relied upon in investment or benefit decisions. The author is not acting in an investment, tax, legal, benefit, or any other advisory capacity. This is not an investment or benefit research report. The author’s opinions expressed herein address only select aspects of various federal benefits and potential investment in securities of the TSP and companies mentioned and cannot be a substitute for comprehensive investment analysis. Any analysis presented herein is illustrative in nature, limited in scope, based on an incomplete set of information, and has limitations to its accuracy. The author recommends that retirees, potential and existing investors conduct thorough investment and benefit research of their own, including detailed review of OPM guidance for benefit issues and for investments the companies’ SEC filings, and consult a qualified investment adviser. The information upon which this material is based was obtained from sources believed to be reliable, but has not been independently verified. Therefore, the author cannot guarantee its accuracy. Any opinions or estimates constitute the author’s best judgment as of the date of publication, and are subject to change without notice. The author explicitly disclaims any liability that may arise from the use of this material.

4 Responses to “Open Season Health Plan Review & Changes”

Dennis, regarding your article of 11/24/2019, are you aware that BCBS Basic is offering a MRA of $800 per person reducing your payment from 386.99 to 253.66 which is less than GEHAs Self-Plus-One Standard of $282.05?

Yes, my next artilce, that will be sent out December 1st, provides a more indepth evaluation of the two plans, BCBS Basic to GEHA Standard. This is a tricky subject, the reimbursement is $800 per person. Reimbursement goes up to $1,600, $800 per person only if both are enrolled in Medicare A & B and you can only apply for the reimbursement after you accure the $1600 in Medicare costs later in the year. The reimbuirsement process is lengthly and requires verification of Medicare payments, etc. The drawback for many is that BCBS doesn’t provide any out-of-network coverage and there are other considerations. Both plans are good and I’ve been in both over the past 20 years. Let me know if the next article better describes the differences and covers the reimbursement issue better.

Dennis -Very helpful articles on FEHB changes one you get Medicare. As a retired fed and retired military, I haven’t found much on those who reeive Medicare A & B, Tricare for Life and FEHB. Is it overkill to keep all three?

Tricare requires participants to have Medicare A & B. If you have Tricare you can “suspend” your FEHB healthcare coverage and use Tricare for Life in conjunction with Medicare A & B. Review information on how to suspend FEHB coverage.(https://www.federalretirement.net/fehb.htm#Canceling_Coverage_in_Retirement. You have to evalute the benefits of the two plans, FEHB to Tricare, to determine which would be best for your personal curcumstances. If you decide to not stay with the FEHB program it isn’t advisable to cancel FEHB coverage. If you sinply cancel your FEGB plan you won’t be able to return to it at a later date, you can return to FEHB if you suspend coverage.

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